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Decatur Memorial Hospital: what a joint replacement costs

Decatur, IL 62526 · CMS Certification Number 140135. What Medicare pays this hospital for knee, hip and shoulder replacement, what it lists, how it compares, and what a surgery center nearby is paid.

Surgery center nearby
—
No orthopedic surgery center within 25 miles
Outpatient here
$12,057
236 Medicare cases, APC 5115
Inpatient here
$15,539
15 Medicare stays, MS-DRG 470

Medicare prices at Decatur Memorial Hospital

OperationInpatient paidList priceList ÷ paidOutpatient allowed
Hip or knee replacement$15,539$94,2176.1×$12,057
Shoulder replacement$22,730$164,2937.2×$17,185
Hip replacement after a fracture (DRG 522)$15,104$80,7195.3×—

Quality

Complications after hip or knee replacement: 4.9% (no different from the national rate). Readmissions: 6.5%. Overall Care Compare rating: 3 of 5 stars. Nonprofit · Acute · 372 beds

Illinois requires a certificate of need for new surgery centers.

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Questions

How much does Medicare pay Decatur Memorial Hospital for a knee or hip replacement?

In 2024 Medicare paid Decatur Memorial Hospital an average of $15,539 per inpatient hip or knee replacement stay (MS-DRG 470, 15 stays) and $12,057 per outpatient case (APC 5115, 236 cases).

What is Decatur Memorial Hospital's list price for a joint replacement?

The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $94,217, 6.1× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.

How does Decatur Memorial Hospital compare with other Illinois hospitals?

Medicare paid Decatur Memorial Hospital more than 62% of the 45 Illinois hospitals that report inpatient hip or knee replacement.